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Volume 21 No. 35
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Injury database guides NFL’s decisions on rules

Before 2011, the NFL’s approach to collecting injury data was fairly routine and hadn’t changed much over previous decades: collect the information, put it into a spreadsheet, and that was about it.

That changed five years ago when the NFL hired Quintiles, a publicly traded health care services company based in Durham, N.C., that is focused on data analysis. Quintiles helped the league overhaul how it collects, analyzes and acts on the information, one element of the data revolution that has swept sports in so many areas.

The NFL relies heavily on Quintiles’ input on an array of decisions, including playing rules changes designed to protect players’ health and safety.

Team trainers use electronic medical records to record every player injury.
Photo by: Getty Images
“It is used regularly to try to understand if rules changes were successful in reducing injuries,” said Nancy Dreyer, Quintiles’ global chief of scientific affairs and senior vice president, real-world and late-phase research.

Quintiles won’t divulge how much data it collects or the conclusions it offers, but it did offer to walk SportsBusiness Journal through the process, something it has rarely if ever done before for the media.

The first critical element is that Quintiles utilizes electronic medical records. No more spreadsheets, but the data is inputted into an EMR that is available to team health personnel. Quintiles tutors team personnel on how to fill out the electronic forms; a key issue with any EMR because one misplaced input can skew the analysis.

“We have athletic trainers work closely with team physicians to record every single injury, how to report it, where to record the information,” Dreyer said.

Quintiles sends monthly reports to team trainers and medical personnel, with the month’s data and analysis.
Quintiles also keeps track of media reports, to check if the injuries inputted into the EMR are missing those reported in the news.

“If something is reported as an injury and is not reflected in the medical report [we get from the team] we ask team medical staff and find out what happened,” said Christina Mack, Dreyer’s colleague and Quintiles’ director of epidemiology and outcomes research. Mack declined to say how often that occurs.

Quintiles has changed how the NFL categorizes injuries. No longer is it enough to put down that a player tore his ACL or suffered a concussion. How the injury occurred is critical in the EMR submission.

“It is too simple to just count concussions,” Dreyer said. Did the concussion occur with the head hitting the turf or on a particular play sequence like a kickoff? This all must get inputted into the EMR for later analysis.

Quintiles also works directly with the NFL’s medical committees, whose members are largely outside experts. If a particular committee, for example, is looking at how a helmet technology might influence injuries, Quintiles is called in to assess the data.

And what about the contention that players hide the symptoms of injuries, which if true could undermine Quintiles’ work? The two epidemiologists point to the new medical spotters at games, and neurologists on the sidelines, as well as their own work reviewing media reports about games.

On concussions, Mack said, “I am confident we get the majority, hard to say all.”

Quintiles works across the globe with scores of companies encompassing 9 million people, and Dreyer and Mack call the NFL EMR now one of the most comprehensive they have encountered.

“We understand big data,” Breyer said. “We are seeing a sophisticated league that is interested in understanding all aspects” of using data to prevent injuries. “As far as we can see nothing is off limits to looking for a safer game.”